Questions and Answers about Arthritis Pain
-- Because people with osteoarthritis
have very little inflammation, pain relievers such as acetaminophen (Tylenol*)
may be effective. Patients with rheumatoid arthritis generally have pain caused
by inflammation and often benefit from aspirin or other nonsteroidal
anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin or Advil).
Heat and cold -- The decision to use either heat or cold
for arthritis pain depends on the type of arthritis and should be discussed
with your doctor or physical therapist. Moist heat, such as a warm bath or
shower, or dry heat, such as a heating pad, placed on the painful area of the
joint for about 15 minutes may relieve the pain. An ice pack (or a bag of
frozen vegetables) wrapped in a towel and placed on the sore area for about 15
minutes may help to reduce swelling and stop the pain. If you have poor
circulation, do not use cold packs.
Joint Protection -- Using a splint or a brace to allow
joints to rest and protect them from injury can be helpful. Your physician or
physical therapist can make recommendations.
Transcutaneous electrical nerve stimulation (TENS) -- A
small TENS device that directs mild electric pulses to nerve endings that lie
beneath the skin in the painful area may relieve some arthritis pain. TENS
seems to work by blocking pain messages to the brain and by modifying pain
Massage -- In this pain-relief approach, a massage
therapist will lightly stroke and/or knead the painful muscle. This may
increase blood flow and bring warmth to a stressed area. However,
arthritis-stressed joints are very sensitive so the therapist must be very
familiar with the problems of the disease.
Acupuncture -- This procedure should only be done by a
licensed acupuncture therapist. In acupuncture, thin needles are inserted at
specific points in the body. Scientists think that this stimulates the release
of natural, pain-relieving chemicals produced by the brain or the nervous
Osteoarthritis and rheumatoid arthritis are chronic diseases
that may last a lifetime. Learning how to manage your pain over the long term
is an important factor in controlling the disease and maintaining a good
quality of life. Following are some sources of long- term pain relief.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
These are a class of drugs including aspirin and ibuprofen that are used to
reduce pain and inflammation and may be used for both short-term and long-term
relief in people with osteoarthritis and rheumatoid arthritis.
Disease-modifying anti-rheumatic drugs (DMARDs) -- These
are drugs used to treat people with rheumatoid arthritis who have not responded
to NSAIDs. Some of these include methotrexate, hydroxychloroquine,
penicillamine, and gold injections. These drugs are thought to influence and
correct abnormalities of the immune system responsible for a disease like
rheumatoid arthritis. Treatment with these medications requires careful
monitoring by the physician to avoid side effects.
Corticosteroids -- These are hormones that are very
effective in treating arthritis. Corticosteroids can be taken by mouth or given
by injection. Prednisone is the corticosteroid most often given by mouth to
reduce the inflammation of rheumatoid arthritis. In both rheumatoid arthritis
and osteoarthritis, the doctor also may inject a corticosteroid into the
affected joint to stop pain. Because frequent injections may cause damage to
the cartilage, they should only be done once or twice a year.